When we talk about the spread of disease, coughs and sneezes immediately come to mind. Yet one of the major ways diseases spread happens when we touch a surface previously touched by an ill person or touch their hands directly.
To promote handwashing, hygiene brand Dettol went round to schools in October 2017 to teach children about the value of good hand hygiene.
The article contained several claims about the toll of diarrhoea and we zoomed in on two. Both were attributed to the US Centers for Disease Control and Prevention’s (CDC) Information on Water-related Hygiene page.
Communicable diseases are a broad category which includes all infections that can be spread from one person to another, whether directly or indirectly. Included in this category are diarrhoea and a number of respiratory infections, such as pneumonia or flu. (Note: Keep in mind that some of the multitude of diseases in this category have nothing to do personal hygiene per se – such as malaria, which is transmitted by mosquitoes.)
The CDC page Dettol provided as source does not contain the claim. It states that “washing hands with soap and water could reduce diarrheal disease-associated deaths by up to 50%” and that it “can reduce the risk of respiratory infections by 16%”.
Africa Check asked Dettol’s public relations company for the correct citation, but is yet to receive it from Ogilvy SA’s Brenda Sono.
When we only look at diarrhoeal illnesses, a recent pooling of 22 studies including 54,006 participants across the globe by the Cochrane Group, found a more modest reduction of 30% (at least during the period that hand-washing was actively promoted).
“The degree of infection-reduction obtained by hand hygiene depends on the type of communicable disease, disease transmission and context,” Prof Didier Pittet, director of the department for hospital hygiene at the Geneva University Hospitals, told Africa Check.
“In healthcare settings, infection reduction studies report between 30% to 100% reduction, depending on the type of intervention and handwashing-agent used,” he said.
However, the quality of the research conducted on general communities is not nearly as rigorous. The implication is that any data on the reduction of infection risk is dependant on the specific disease being studied, as well as the context in which the analysis takes place.
Furthermore, the kind of handwashing required to really make a difference involves more than a quick splash. The Center for Disease Control’s guide explains you need to scrub for at least 20 sec with soap and water before and after you’re likely to handle germs – for example, before preparing food or after playing with an animal.
Dettol’s press release claims this statistic was sourced from a 2015 study called “Making Common Infections Uncommon Study” by the Global Hygiene Council, an advocacy and research group funded by Dettols’ parent company, Reckitt Benckiser.
Africa Check was unable to find a copy of this online, but Ogilvy promised to trace it. We are yet to receive it, though.
However, the same claim appears on the CDC’s Global Diarrhoea Burden page, citing a 2012 paper published in The Lancet medical journal. As part of this study, global death statistics for children under five were examined. Data was drawn from 2010 estimates, with any gaps filled in by extrapolating from existing trends from 2000 onwards.
The 2010 data contradicts the claim, however. Of the 7.6 million deaths in children under five around the world in 2010, nearly two-thirds (64%) were due to infectious causes. Among these, diarrhoea was responsible for 801,000 deaths, with malaria (564,000), AIDS (159,000) and measles (114,000) taking a greater toll at 837,000 deaths.
“While you are right that the claim is not correct using the data for 2010, that reference is very out of date,” one of the study’s co-authors, Prof Robert Black, told Africa Check. he is a professor of international health at the Johns Hopkins Bloomberg School of Public Health in the US.
The World Health Organization’s latest estimates (for 2015), shows diarrhoeal deaths leading at 526,000 child deaths, with the other three causes add up to 466,000 deaths – malaria (306,000), AIDS (86,000) and measles (74,000).
What about South Africa, where the article appeared?
Here the claim does not hold up. The most recent figures from the South African Medical Research Council shows HIV alone was responsible for 20.1% of under-5 deaths (9,600) in 2012, while diarrhoeal illnesses made up 16.5% (7,880).
Previous report #5facts: Water in South Africa
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